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  1. University of Arkansas for Medical Sciences
  2. Winthrop P. Rockefeller Cancer Institute
  3. Daniela Ochoa

Daniela Ochoa

Breast Cancer Didn’t Steal Little Rock Woman’s Zeal for Life

Oct. 12, 2017 | The past year and a half has included many challenges for Josephine Guiden — being diagnosed with cancer, then chemotherapy, surgery and radiation treatments— but none of them have snatched her passion for life.

“There’s power in knowing you have to be positive about life,” said the 70-year-old Little Rock resident. “You only come this way once and you have to make the best of it while you’re here.”

Guiden’s taxing journey began in May of 2016 when she discovered a knot in her breast under her right arm. She recognized immediately it could be cancer.

“It was shocking, but through years of mammograms and exams, physicians tell you what the knot will feel like,” she said. “You don’t quite get it then, but when I felt that knot, I knew it was malignant. I knew it was cancer.”

She called her doctor and had a previously scheduled mammogram moved up, but in the meantime, went on a bus trip to New York with the Patrick Henry Hays Senior Center in North Little Rock.

“I had lots of fun,” she said, “but my energy level was low.”

When she returned, her mammogram and biopsy confirmed what she already suspected: breast cancer. However, at stage 3 it was more advanced than she expected.

“There was anxiety and fear when it was confirmed and it was so advanced that I was upset with myself,” she said. “Even though I expected the diagnosis, I came home afterwards and had a good cry. But I knew I had to stay positive, I had to pray about the situation and that’s what I did. I told God, ‘I choose life. I want to live.’”

She was shepherded through the next several months of treatment by Daniela Ochoa, M.D., breast surgeon in the UAMS Winthrop P. Rockefeller Cancer Institute and assistant professor of surgery in the Division of Breast Surgical Oncology in the UAMS College of Medicine; Issam Makhoul, M.D., director of the UAMS Division of Hematology/Oncology and associate professor in the College of Medicine; and Loverd Peacock, M.D., radiation oncologist in the Cancer Institute and faculty member in the Department of Radiation Oncology in the College of Medicine.

“They were my guardian angels,” said Guiden. “I was placed in the midst of three great doctors who made me feel so special that no one could have ever convinced me that I wasn’t their favorite patient.”

Ochoa said the whole-team approach is one of the benefits to breast cancer treatment at UAMS.

“We have specialists who practice only in breast cancer — from radiologists and oncologists to geneticists, pathologists and behavioral health specialists,” said Ochoa. “We have team members who work closely in managing breast cancer patients and are able to provide a consensus opinion, and our patients benefit from that.”

A few days after her diagnosis, Guiden received her port for chemotherapy treatment. The first series of treatment lasted 12 weeks. In the three-week hiatus between her first and second rounds of chemotherapy, she took another cross-country bus trip. This time to Martha’s Vineyard in Massachusetts.

She began her second round of chemotherapy the day after she returned and completed it just before Thanksgiving. On Dec. 27, she had a lumpectomy, a surgery to remove the tumor, performed by Ochoa. Then she received radiation treatment for five weeks from Peacock.

Throughout her treatment regimen, Guiden says she relied on her faith, family, friends and fellow church members at St. John Missionary Baptist Church in Little Rock for support.

There was her Sunday School teacher who gave her a scripture after her diagnosis, Psalms 117:17-18, that she carried with her daily; countless prayers with her Sunday School class; her two sisters and a close friend who stopped by often to help with household chores and cooking; her son who did yard work; and her brothers who helped make sure she didn’t miss a family reunion gathering.

“I was surrounded by a wonderful group of people that supported me,” she said.

In May, one year after her diagnosis, Guiden had another mammogram performed. She was cancer free. Guiden could barely contain herself when she saw Ochoa following the exam.

“I just grabbed her and almost picked her up off the floor,” she said. “I was so happy to have the relief. There was quite a bit of anxiety prior to the mammogram because you don’t know what to expect or what will be there.”

Ochoa said Guiden’s story conveys the importance of monthly self-examinations.

“I’ll often hear patients say they don’t know what they’re feeling for, but the idea is to be familiar so something new will stand out and feel different. The monthly interval is important because it’s enough of a timeframe that you’ll notice a difference if it occurs.”

Looking back, Guiden sees that importance, too.

“It’s so important to do self-exams,” she said. “If I had done that, I would have found this sooner, but I stopped. That was the culprit, me not taking stock in myself and my well-being.”

Filed Under: Cancer Featured Stories, Patient Stories, UAMS News Tagged With: Arkansas hospitals, Daniela Ochoa, Issam Makhoul, Josephine Guiden, Loverd Peacock, UAMS, UAMS College of Medicine, UAMS Winthrop P. Rockefeller Cancer Institute

Inherited Cancer Risk Leads Travel Blogger to Choose Mastectomy

April 14, 2017 | Lesley Murphy is accustomed to waking up in exotic locations. From snow-covered Finland to the beaches of Bali, this 29-year-old professional blogger spends more than 300 days a year documenting her travels to vacation destinations around the world.

“My number one goal is inspiring travel and showing people that if they get out of their comfort zones, they can make the world a better place,” she said.

Recently, however, the Arkansas native took a detour from her globetrotting lifestyle to focus on a very different subject — her future health. About three years ago, Lesley was living in Argentina when she received the call that her mother, Martha Murphy, was diagnosed with breast cancer. With no history of breast cancer in her family, the diagnosis came as a shock.

“It was my first year living abroad, and I felt so far away,” Lesley said. “It was a wash of emotions. You never want to hear the words ‘mom’ and ‘cancer’ in the same sentence.”

Martha Murphy, who was living in Fort Smith at the time, felt a lump in her breast before scheduling a mammogram in early March 2014. After it was confirmed she had stage 1 breast cancer, Martha immediately sought the advice of her next-door neighbor, who happened to be an oncologist. He recommended genetic testing to determine if she might have a mutation of one of the BRCA genes, commonly known as the breast cancer genes.

While every person is born with the BRCA1 and BRCA2 genes, women who inherit mutations of the genes have up to an 80 percent chance of developing breast cancer by age 70. If Martha tested positive for a gene mutation, it would mean her three adult daughters had the potential for it as well.

“My doctor in Fort Smith ordered the genetic test on the same day I was diagnosed, but it took a few days to receive the results,” Martha said.

The morning after her diagnosis, Martha decided she wanted to seek a second opinion at UAMS, Arkansas’ only academic health sciences center. After a reassuring visit on March 21 with breast surgeon V. Suzanne Klimberg, M.D., director of the Breast Cancer Program at the UAMS Winthrop P. Rockefeller Cancer Institute, Martha scheduled a double mastectomy for 10 days later.

Her breast reconstruction surgery was completed at UAMS in August, followed by an oophorectomy to remove her ovaries in September. A BRCA gene mutation also can increase a woman’s risk of developing ovarian cancer.

“When I look back, this experience was just a blip on my radar. While it was happening, I was in the midst of helping my eldest daughter plan her wedding. I didn’t have time to focus on myself, so I’m terribly blessed that I didn’t have any complications or need any chemo or radiation,” Martha said.

Klimberg also is a professor of surgery and pathology in the UAMS College of Medicine and director of the Division of Breast Surgical Oncology.

Martha received the results of her genetic test prior to her visit with Klimberg and was surprised to discover she did indeed carry the BRCA2 gene mutation. She immediately knew that she wanted her daughters to be tested as well.

“I told them, this is what we’re going to do. They needed to know if they had the gene mutation, so they could make informed decisions about their future,” Martha said.

Each child of a parent — mother or father — who carries a mutation in one of the BRCA genes has a 50 percent chance of inheriting the mutation.

Martha’s eldest daughter, Lauren, and youngest, Jordan, both underwent testing at the UAMS Cancer Genetics Clinic and received mixed results.

“After Jordan’s test came back negative, we were hopeful they all would,” Martha said.

That would not be the case, as Lauren’s results were soon found to be positive for her mom’s BRCA2 mutation. The UAMS Cancer Institute is home to the only clinical cancer genetics team in Arkansas. Although any doctor can order genetic testing — which is conducted using a blood or saliva sample — UAMS has the only board-certified geneticists and genetic counselors in the state who can diagnose rare syndromes and manage complex cancer syndromes, of which there are more than 50.

As for Lesley, finding time for the genetic screening was a challenge in itself. Because she was living in South America, did not have domestic insurance, and was launching her career as a travel blogger, the sense of urgency wasn’t strong.

“I would be in Arkansas for two days and then gone for a month, so there was never any time to schedule it. Two years went by before I was home for an extended time. That’s when Mom encouraged me to get it done,” said Lesley, who initially gained fame as a contestant on season 17 of ABC’s “The Bachelor.”

When her genetic test came back positive for the BRCA2 gene mutation, Lesley knew she had some choices to make. She looked to Kent McKelvey, M.D., director of Cancer and Adult Genetics Services, and the UAMS Cancer Genetics Clinic staff for guidance.

“Each person ultimately has to make the choices that are best for themselves and their families. We are here to help people understand the evidence and options and guide them to make the best informed decisions,” said McKelvey, who also is associate professor in the UAMS College of Medicine Division of Genetics.

For Lesley, those choices were to undergo breast cancer screenings every six months in an attempt to catch any tumors in their earliest stages or have a preventive double mastectomy, followed by reconstruction. With her travel career in full swing, Lesley said the choice was clear.

“Because of my schedule, I didn’t foresee the twice-yearly screenings as a realistic option. While it may sound drastic to some people, having the surgery was definitely the best option for me,” she said.

The fact that Lesley was able to learn about her gene mutation and make the best choice for herself provides a sense of freedom and empowerment, McKelvey said.

“Given her active career and the fact that she gave this decision serious consideration, her choice to have elective surgery makes perfect sense,” he said.

Following the double mastectomy with UAMS breast surgeon Daniela Ochoa, M.D., Lesley’s risk of developing breast cancer will be reduced by about 95 percent. Nothing can eliminate the risk entirely, McKelvey said, however, surgery is the most effective strategy to dramatically reduce her risk of breast cancer and eliminate any future need for screenings. Ochoa is a professor of surgery in the UAMS College of Medicine Division of Breast Surgical Oncology.

Because of her public image and large social media following, Lesley chose to document her experience on social media channels including Instagram, Facebook, Twitter and Snapchat.

“I saw this as a way to educate people and encourage them to be more knowledgeable about their own personal health decisions,” she said.

After a four-week break from traveling following her April mastectomy, Lesley will hit the road again in May, this time with Mom by her side.

“The doctors think I’ll be fine to travel by then, but she’ll be there for support if I need it,” Lesley said.

She will return to UAMS in late summer to complete her breast reconstruction process under the direction of plastic surgeon Eric J. Wright, M.D., associate professor in the UAMS College of Medicine Division of Plastic and Reconstructive Surgery.

Then, it’s back on a plane to her next destination. “I will always travel. I don’t know what my career will eventually evolve into, but travel is definitely what I’m passionate about and what makes me happy,” Lesley said.

Filed Under: Cancer Featured Stories, UAMS News Tagged With: arkansas, BRCA1, BRCA2, breast cancer, cancer, Daniela Ochoa, Eric Wright, genetics, kent mckelvey, Lesley Murphy, mastectomy, Suzanne Klimberg, The Road Les Traveled, UAMS, Winthrop P. Rockefeller Cancer Institute

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